ArticleInternational journal of chronic obstructive pulmonary disease2026
Admission Systemic Immune-Inflammation Index and 90-Day AECOPD-Related Unplanned Readmission: A Single-Center Retrospective Cohort Study.
Article in International journal of chronic obstructive pulmonary disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The systemic immune-inflammation index (SII) is derived from routine blood counts, but its incremental value for disease-specific early readmission after acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remains uncertain. We evaluated the association between admission SII and 90-day AECOPD-related unplanned readmission and its value beyond available clinical variables. Methods: This single-center retrospective development cohort included 207 unique patients hospitalized for AECOPD from January 2024 to January 2025; only the first eligible hospitalization per patient was analyzed. Readmissions were ascertained from electronic records and structured telephone follow-up completed on June 30, 2025. SII was calculated from the first blood count obtained within 24 hours of arrival. Logistic regression, receiver operating characteristic analysis, 1000-resample bootstrap internal validation, calibration assessment and decision curve analysis were performed. Bootstrap validation assessed optimism in discrimination, calibration and net benefit. Results: Seventy-eight patients (37.7%) experienced AECOPD-related unplanned readmission within 90 days. Each 500-unit increase in SII was associated with higher adjusted odds of readmission (odds ratio 1.329, 95% confidence interval 1.153-1.530; p < 0.001). Apparent AUC was 0.809 (95% confidence interval 0.742-0.869) for the integrated model versus 0.752 (0.678-0.821) for the limited clinical model. The absolute increase was 0.057 (bootstrap 95% confidence interval 0.014-0.101), and adding SII improved model fit (likelihood-ratio p < 0.001). Optimism-corrected AUC, calibration intercept and slope were 0.785, -0.003 and 0.874. Otherwise identical NLR and PLR models had corrected AUCs of 0.775 and 0.765; pairwise differences were inconclusive. Conclusion: Higher admission SII was associated with 90-day AECOPD-related unplanned readmission and improved discrimination beyond a limited clinical model. These exploratory single-center findings require external validation, recalibration and prospective impact assessment before clinical implementation.
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